Erdal Apaydin

Women with low libido: correlation of decreased androgen levels with female sexual function index

The aim of the present study was to investigate a possible correlation between decreased androgen levels and female sexual function index (FSFI) in women with low libido and compare these findings with normal age-matched subjects. In total, 20 premenopausal women with low libido (mean age 36.7; range 24–51 y) and 20 postmenopausal women with low libido (mean age 54; 45–70 y), and 20 premenopausal healthy women (mean age 32.2; range 21–51 y) and 20 postmenopausal healthy women (mean age 53.5; range 48–60 y) as controls were enrolled in the current study. Women with low libido had symptoms for at least 6 months and were in stable relationships. All premenopausal patients had regular menstrual cycles and all postmenopausal patients and controls were on estrogen replacement therapy. None of the patients were taking birth control pills, corticosteroids or had a history of chronic medical illnesses. All completed the FSFI and Becks Depression Inventory (BDI) questionnaires. Hormones measured included: cortisol; T3, T4 and TSH; estradiol; total and free testosterone; dehydroepiandrosterone sulfate (DHEA-S); sex hormone binding globulin (SHBG). We performed statistical analysis by parametric and nonparametric comparisons and correlations, as appropriate. We found significant differences between the women with low libido and the controls in total testosterone, free testosterone and DHEA-S levels and full-scale FSFI score for both pre- and postmenopausal women (P<0.05). In addition, decreased total testosterone, free testosterone and DHEA-S levels positively correlated with full-scale FSFI score and FSFI-desire, FSFI-arousal, FSFI-lubrication and FSFI-orgasm scores (P<0.05). Our data suggest that women with low libido have lower androgen levels compared to age-matched normal control groups and their decreased androgen levels correlate positively with female sexual function index domains.

Eosinophilic cystitis induced by Mitomycin-C

Eosinophilic cystitis is an unusual form of cystitis which is characterized by irritative voiding symptoms and haematuria. In the report herein two adult cases of eosinophilic cystitis treated with intravesical Mitomycin-C instillations for prophylaxis of bladder carcinoma are presented and the literature is reviewed.

Transrectal ultrasonography-guided echo-enhanced seminal vesiculography in combination with transurethral resection of the ejaculatory ducts.

routinely aspirated for motile spermatozoa. All intraoperative aspirates are cryopreserved for intracytoplasmic sperm injection (ICSI) if microscopic examination shows motile spermatozoa and the volume is sufficient for harvesting. The mixture of Levovist and methylene blue dye is then administrated under real-time TRUS guidance. The patency of the ipsilateral ejaculatory duct is confirmed by directly visualizing the contrast solution as it flows through the seminal vesicle, the ampulla of the vas deferens and the ejaculatory duct, and then passes into the prostatic urethra and the bladder. The procedure is then repeated for the contralateral seminal vesicle. At the same time seminal vesicles, ejaculatory ducts and the prostatic urethra can be clearly visualized for the level of obstruction, obstructed length, distance to the cyst and distance to the rectum (Fig. 2) After evaluating these variables a strategy for the operation is selected.

Systemic Absorption of Gentamicin in Penile Prosthesis Operations

Irrigation with antibiotic solutions is frequently used in penile prosthesis surgery to avoid infection. We carried out a prospective study to determine the degree of absorption of gentamicin after intracavernous irrigation in 10 patients who underwent penile implantation surgery. All obtained values were below the toxic level of 10 micrograms/ml and decreased gradually within a few hours. We concluded that highly concentrated gentamicin solutions could be used with safety for intracavernous irrigation.

LAPAROSCOPIC AND ROBOTIC PYELOPLASTY: OUTCOMES AND FEASIBILITY FOR COMPLEX PATIENTS

LRP vs RALP Surgical Outcomes LRP RALP P Patients (n) 75 75 Age (yrs) 59.6 (43-72) 59.8 (42-71) 0.88 Mean PSA (ng/mL) 7.5 8.7 0.22 Stage pT2 71 64 0.09 pT3 4 11 0.09 Gleason Grade =8 3 1 0.62 Operative Time (min) 232 (170-385) 199 (73-360) <0.001 EBL (cc) 311 (100-800) 230 (50-1500) 0.004 Open Conversion 0 7 Length of Stay (days) 3.4 (2-12) 1.95 (1-7) <0.0001 Margins Positive 10 (13.7%) 9 (12%) 0.375 Positive Margins by Stage pT2 9/71 (12.7%) 7/64 (10.9%) 0.322 pT3 1/4 (25%) 2/11 (18%) 0.571